Hi everyone,
During my first year of medical school, I lived on the top floor of Bard Hall, an old brick building which featured a dining room, squash courts, and performance spaces. My room had a spectacular view, overlooking the Hudson River, the George Washington Bridge, and the Palisades.
All VP&S students know about Samuel Bard, an 18th century physician and founder of the school, who cared for George Washington and delivered the first born son of Alexander Hamilton. Few of us realized, though, that Bard was also a slaveholder and, for that reason, Columbia recently decided to remove his name from the dorm.
Columbia’s decision pushed me to think about my training in the 1980s, particularly how we were taught to cite race in our notes and presentations, opening with “this is a 55-year-old white man” or “this is a 43-year-old black woman.” Few of us questioned the rationale, let alone the appropriateness, of this time-honored system.
Today, we rarely cite race in our presentations, and at first glance, this makes sense. Ample scholarship has negated race as a biological concept and more appropriately recognizes it as a uniquely American social construct, serving initially to justify slavery and, later, Jim Crow. Given medicine’s long history of systemic racism, including the abuse of research subjects, the provision of inferior medical care, the use of biased PFT standards, and the underrepresentation of minority students in medical school, deleting race from our presentations may signal our collective hope to treat all patients equally.
But I worry that excluding race from presentations amounts to little more than empty symbolism, suggesting somehow that medicine has entered a “post-racial” phase, which, of course, it has not. Worse, by failing to recognize race, we may undermine our unfinished work, by inadvertently obscuring persistent health disparities, such as inferior cancer treatment and higher rates of heart disease, gun violence, and COVID-19. If we fail to discuss racism, our work to end disparities will fail as well.
So where and when should we discuss racism? I think the answer is everywhere and now. If we limit our antiracism work to deleting race from Chief Concerns or removing slaveholders’ names from buildings, we won’t achieve much. We cannot and should not pretend we “don’t see color.” To fight racism, we need to recognize it, acknowledge it, discuss it, and correct it when we see it.
Yours in solidarity, everyone. Have a good Sunday,
Mark
PS for further reading:
- Seven things organisations should be doing to combat racism
- Seven more things organisations should be doing to combat racism
- How Medical Education Is Missing the Bull’s-eye (H/T to Sam Magier)
- The Performance of “Antiracism” Curricula
MDS